腹腔镜联合胆道镜胆总管切开取石一期缝合临床效果分析.pdf

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1、口固2014NO．15Medica1论著腹腔镜联合胆道镜胆总管切开取石一期缝合临床效果分析万德礼刘树清吴云光张萍河南省职工医院普外科。河南郑州450002【摘要】目的探讨腹腔镜胆总管切开取石一期缝合的可行性及临床应用价值。方法总结2008年9月一2Ol3年5月54例胆总管切开取石一期缝合的临床资料(观察组)，与同期行腹腔镜胆总管切开取石T管引流97例(对照组)进行临床效果对比分析。结果一期缝合组较T管引流组的术后疼痛轻、胃肠道功能恢复快、住院时间短、临床费用低<0．05)，两组手术时间及术中出血量差异无统计学意义(尸>O．05)，均无胆漏、胆管狭窄、结石

2、残留等并发症及再次手术发生。结论腹腔镜胆总管切开取石一期缝合安全可行，具有微创、康复快、疼痛轻、住院时间短、临床费用低等优点，但应注意适应证的选择，术中需精细、规范操作。【关键词】胆总管结石；腹腔镜检查；胆道镜检查；胆总管切开取石术；一期缝合【中图分类号】R657．4【文献标识码】A【文章编号】1674—0742(2014)05(c)一0028—03TheClinicalEfectAnalysisofLaparoscopicCholedocholithotomyCombinedCh0led0ch0sc0pewithPrimarySutureWANDeli

3、LIUShuqingWUYunguangZHANGPing、DepartmentofGeneralSurgery，HenanProvincialWorkersHospital，Zhengzhou，HenanProvince，450002，China[Abstract]ObjectiveToinvestigatethefeasibilityandclinicalvalueoflaparoscopicch0led0ch0lithot0mywithprimarysuture．MethodsTheclinicaldataof54patientssuferedfr

4、omcholedocholithiasis(observationgroup)underwentlaparoscopiccholedo—cholithotomywithprimarysuturefromSeptember,2008toMay，2013weresummarized．And97casesunderwentlaparoscopiecholedocholithotomyT—tubedrainageduringthesameperiodwereselectedasthecontrolgroup．Theclinicalefectswerecom—pa

5、redbetweenthetwogroups．ResultsComparedwiththeT—tubedrainagegroup，theprimaryductclosuregrouphadlesspain，fasterrecoveryofgastrointestinalfunction，shorterpostoperativehospitalstayandlesshospitalcosts(P<0．05)．Therewasnosignifi—cantdiferenceintheoperationtimeandintraoperativebloodloss

6、betweenthetwogroups(P>0．05)；ThereWasnobileleakage，bileductstricture，residualstonesandreoperationinallthepatients．ConclusionLaparoscopiccholedocholithotomywithprimarysutureissafeandfeasible．Ithastheadvantagessuchasminimalinvasion，quickrecovery，littlepain，shorthospitalstayandlowcos

7、t．However，theselectionofindicationsshouldbenotedandthesurgeryneedstobefinelyandstandardlyoperated．[Keywords]Choled0ch01ithiasis；Lapamscopy；Cho1edoch0scopy；Choledocholithotomy；Primarysuture随着腹腔镜技术的不断发展和进步，腹腔镜胆总管切开取1资料与方法石现已成为治疗肝外胆管结石的常规手术【11。而术者大多数采1．1一般资料用的是胆总管切开取石后T管引流术，为探讨腹腔镜胆总

8、管切选取该院收治的肝外胆管结石病例中，选取腹腔镜胆总管探开取石一期缝合的可行性及